慢性萎缩性胃炎(chronic atrophic gastritis,CAG)是临床常见的消化系统疾病,与胃癌的发生关系密切.该病病程较长,初期往往并无特殊不适.随着病情进展,多表现为上腹痛、腹胀、早饱、嗳气等消化不良症状.CAG作为胃癌前疾病的一种,若不予以重视和及时治疗,发展为胃癌的可能性较大.研究发现,高浓度胆汁酸患者的胃癌发病率明显高于其他患者.肠道菌群作为人体肠道内的正常微生物,被发现在胆汁酸的合成代谢过程中发挥重要作用.与胆汁酸代谢形成密切相关的胆汁酸-菌群轴或与CAG的发生及进展有关,甚至可导致胃癌.中医认为,脾虚血瘀是CAG的核心病机,胆汁酸-菌群轴与CAG的相关性有重要研究价值.本文以"胆汁酸-菌群轴"为切入点,探讨CAG脾虚血瘀证的病机内涵,以期进一步认识CAG的发病机制.

Background: Ginseng consumption has been associated with various health outcomes. However, there are no review articles summarizing these reports. Methods: PubMed, Embase, the Cochrane Library of Systematic Reviews, Scopus, CNKI and Wanfang databases were searched from inception to 31 July 2022. The Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) systems were used to assess the methodological quality and quality of evidence in each meta-analysis, and the results were summarized in a narrative form. Results: Nineteen meta-analyses that met the eligibility criteria were identified from among 1,233 papers. The overall methodological quality was relatively poor, with only five studies being low-quality, and 14 critically low-quality. When compared with control treatments (mainly placebo), ginseng was beneficial for improving fatigue and physical function, sexual function, menopausal symptoms, metabolic indicators, inflammatory markers, unstable angina and respiratory diseases. Adverse events included gastrointestinal symptoms and potential bleeding; however, no serious adverse events were reported. Conclusion: This umbrella review suggests that ginseng intake has beneficial therapeutic effects for diverse diseases. However, the methodological quality of studies needs to be improved considerably. In addition, it is imperative to establish the clinical efficacy of ginseng through high-quality randomized controlled trials.

Background:Nigella sativa (N. sativa) consumption has been associated with various health outcomes; however, the results are not completely consistent.Objectives:This overview of systematic reviews and meta-analyses aimed to evaluate the reporting and methodological quality, and to grade the available evidence of associations between N. sativa and health outcomes.Methods:PubMed, Cochrane Library, Embase, and Scopus databases were searched from their inception to September 30, 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 statement, Assessment of Multiple Systematic Reviews (AMSTAR) 2 checklist, and Grades of Recommendations, Assessment, Development and Evaluations (GRADE) systems were used to assess the reporting, methodological, and evidence quality for each meta-analysis, respectively. The results were synthesized in a narrative form.Results:This overview included 20 eligible meta-analyses published in peer-reviewed journals between 2013 and 2021. The overall methodological quality was relatively poor, with only one moderate quality, four low quality, and 15 critically low quality studies. For reporting quality, items two, five, eight, nine, 15, and 24 need to improve. Among the 110 outcome indicators of the quality of evidence, five were graded as moderate, 17 as low, and 88 as very low. Risk of bias, inconsistency, and imprecision were the main downgrading factors.Conclusion:This overview suggests that N. sativa is beneficial for various clinical outcomes. However, there are certain limitations to reporting and methodological quality. The clinical efficacy of N. sativa requires confirmation in high-quality, large-sample, randomized controlled trials.

Berberine is a plant extract widely used in clinical practice. This review aimed to summarize and to grade the available evidence on the association between berberine consumption and health-related outcomes. The PubMed, Cochrane Library, and Embase databases were searched for meta-analyses of randomized controlled trials (RCTs) assessing the efficacy and safety of berberine from inception to June 30, 2022. The AMSTAR-2 and GRADE system were used to assess the methodological quality and evidence level of the included meta-analyses. A total of 11 eligible meta-analyses were identified from 235 publications, which were published in peer-reviewed journals between 2013 and 2022. The results revealed that berberine significantly affects blood glucose levels, insulin resistance, blood lipids, body parameters and composition, inflammatory markers, colorectal adenomas, and Helicobacter pylori infections as compared to controls. Common side effects of berberine consumption include gastrointestinal symptoms, such as constipation and diarrhea. Berberine is a safe medicinal plant ingredient that improves various clinical outcomes; however, there is a need for improvement of methodological quality in published meta-analyses. Additionally, the clinical effects of berberine need to be confirmed in high-quality RCTs.

Objective: To study the distribution of TCM syndromes of gastric mucosal dysplasia and its correlation with pathological changes. Methods: Using a cross-sectional research method and using unified diagnostic criteria, the pathological diagnosis of 480 patients with low-grade/uncertain dysplasia of gastric mucosal was collected, and the four diagnosis information of Traditional Chinese Medicine, such as primary and secondary symptoms, tongue and pulse, were collected to clarify their TCM syndrome types and pathological tissue classification. The database was established, and the data analysis was carried out by using IBM-SPSS 26.0 software. Results: A total of 480 cases were included in this study, there were 261 patients with low grade dysplasia and 219 patients with uncertain dysplasia. The total frequency of single syndrome and complex syndrome in all patients was 706 times, there were 276 patients with single syndrome, 182 patients with two syndromes and 22 patients with three syndromes. The frequency of syndromes was: liver-stomach stagnation-heat syndrome＞spleen and stomach qi deficiency＞blood stasis of stomach collaterals＞damp-heat in spleen-stomach＞spleen and stomach deficiency and cold＞stagnation of qi in liver-stomach＞deficiency of yin in stomach. The age of spleen and stomach qi deficiency syndrome is higher than that of non spleen and stomach qi deficiency syndrome（P＜0.05）. There is a negative correlation between spleen and stomach deficiency and cold syndrome and atrophy range and atrophy degree（P＜0.05）. There was a positive correlation between spleen and stomach qi deficiency and the extent of dysplasia, atrophy, and intestinal chemosis lesions（P＜0.05）. Conclusion: Liver-stomach stagnation-heat syndrome, spleen and stomach qi deficiency, blood stasis of stomach collaterals are common syndromes of dysplasia; spleen and stomach deficiency and cold syndrome is mostly distributed in the early stage of the disease with less atrophy degree and smaller atrophy range; the spleen and stomach qi deficiency is an important link in the pathogenesis of dysplasia, and it is also a key syndrome in the development of lesions and even canceration. It is often accompanied by qi stagnation, blood stasis, stagnant heat, damp heat, etc.

Chronic gastritis(CG)is a chronic inflammation or atrophic lesion of gastric mucosa caused by various reasons.It is mostly due to the repeated invasion of gastric mucosal epithelium by various pathogenic factors,and the reconstruction of the mucosa due to its specific regeneration function,which eventually leads to the irreversible atrophy or even disappearance of the intrinsic glands of the stomach.Modern research shows that chronic inflammation of gastric mucosa can cause malignant changes in cells and eventually lead to the occurrence of gastric cancer,but its mechanism is still unclear.It is currently believed that effective interven-tion of precancerous lesions such as intestinal metaplasia and dysplasia in the background of gastric mucosal atrophy is the key link in secondary prevention of gastric cancer in CG"inflammation-cancer transformation".In traditional Chinese medicine,spleen defi-ciency is an important pathogenesis of CG"inflammation-cancer transformation",and on this basis,factors such as phlegm damp-ness and blood stasis can accelerate its malignant transformation process.This process is highly consistent with mitochondrial energy metabolism in terms of microscopic performance and occurrence.